[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-543149-105":59,"doc-detail-543149-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","pharmacologic-and-nutritional-therapies-in-idiopathic-male-infertility-a-systematic-review-and-meta-analysis","Pharmacologic and Nutritional Therapies in Idiopathic Male Infertility - A Systematic Review and Meta-Analysis","","Pharmacologic and nutritional therapies are frequently used for men with idiopathic infertility, yet intervention-specific effectiveness by mechanism of action remains unclear. A systematic search of PubMed, Embase, Scopus, Cochrane CENTRAL, ClinicalTrials.gov, and Google Scholar (January 2010 to January 2026) identified randomized controlled trials comparing these therapies with placebo or no treatment. Semen parameters were meta-analyzed using three-level random-effects models with Knapp–Hartung adjustment and certainty assessed by GRADE. Antioxidants showed higher semen concentration, motility, and morphology, though evidence certainty was very low and prediction intervals were wide; larger trials reporting live births are needed.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/pharmacologic-and-nutritional-therapies-in-idiopathic-male-infertility-a-systematic-review-and-meta-analysis/543149/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/pharmacologic-and-nutritional-therapies-in-idiopathic-male-infertility-a-systematic-review-and-meta-analysis/543149.png","ImageObject",300,407,{"name":92,"@type":93},"Bulrr","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-21","2026-10-11",true,{"@type":102,"interactionType":103,"userInteractionCount":34},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What treatments does the systematic review evaluate in idiopathic male infertility?","Question",{"text":112,"@type":113},"It evaluates pharmacologic and nutritional interventions, including antioxidants, PDE inhibitors, and methyl donors, and also summarizes hormonal agents narratively.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How were study results analyzed across different intervention classes?",{"text":117,"@type":113},"Semen parameters were pooled using three-level random-effects models stratified by mechanism of action, using Knapp–Hartung adjustment; certainty was assessed with GRADE.",{"name":119,"@type":110,"acceptedAnswer":120},"What were the main findings for antioxidants and semen parameters?",{"text":121,"@type":113},"Antioxidants were associated with higher sperm concentration, progressive motility, total motility, and normal morphology, but certainty was very low and prediction intervals were wide, crossing the null for all outcomes.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},543149,1791829484,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":34,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145},5909892115043,"https://ap-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","Andrology   \n ORIGINAL ARTICLE  \nPharmacologic and Nutritional Therapies in Idiopathic Male Infertility: A Systematic Review and Meta-Analysis  \nSamar J. Melhem1   Motaz Melhem2   Ra’ed Haddad3   Omar Alghurabi4   Rimal Mousa1, 5   Eman Massad5   HamzehAlmomani1   Yazan Alrashdan1   Jamal Melhem6   \n1 Department ofBiopharmaceutics and Clinical Pharmacy, Jordan University Hospital, Amman, Jordan  2 Independent Researcher, Private Urology Clinic, London, UK  3Urology Department, Surrey and Sussex Healthcare NHS Trust, Surrey, UK  4Urology Department, Medway Maritime Hospital, Kent, UK  5 Department of Health Economics and Health Management, Public Health Institute, University of Jordan, Amman, Jordan  6Arab Medical Centre, Amman, Jordan  \nCorrespondence: Samar J. Melhem ([sa.melhem@ju.edu.jo](sa.melhem@ju.edu.jo))  \nReceived: 18 March 2026  Revised: 21 April 2026  Accepted: 30 April 2026  \nKeywords: male infertility | idiopathic | antioxidants | meta-analysis | semen parameters | clinical pregnancy  \nABSTRACT  \nBackground: Pharmacologic and nutritional therapies are prescribed for men with idiopathic infertility, but their effectiveness by intervention class remains uncertain.  \nObjectives: To evaluate these interventions on semen parameters and clinical pregnancy in men with idiopathic infertility, stratified by mechanism of action.  \nMaterials and Methods: We searched PubMed, Embase, Scopus, Cochrane CENTRAL, [ClinicalTrials.gov](ClinicalTrials.gov), and Google Scholar (January 2010 to January 2026) for randomized controlled trials comparing pharmacologic or nutritional interventions with placebo or no treatment in men with idiopathic infertility. Semen parameters were the primary outcomes, analyzed by mechanism of action using three-level random-effects models with Knapp–Hartung adjustment. Certainty of evidence was assessed using GRADE. PROSPERO: CRD420261289976 .  \nResults: Forty-one RCTs (3615 men) were included. Antioxidants were associated with higher sperm concentration (SMD: 1.09, 95% CI: 0.10 to 2.08), progressive motility (SMD: 1.11, 95% CI: 0.32 to 1.90), total motility (SMD: 0.69, 95% CI: 0.26 to 1.13), and normal morphology (SMD: 0.43, 95% CI: 0.05 to 0.82); prediction intervals crossed the null for all. PDE inhibitors showed numerically higher point estimates for concentration (SMD: 1.96, 95% CI: −2.25 to 6.17) and morphology (SMD: 1.28, 95% CI: −0.47 to 3.02); methyl donors reduced DNA fragmentation (SMD: −1.17, 95% CI: −2.82 to 0.47) . Confidence intervals for these included the null. Heterogeneity was substantial (I2 > 80%) . Hormonal agents and clinical pregnancy were synthesized narratively.  \nDiscussion: Pooled estimates represent averages of diverse effects; individual patient responses remain uncertain given wide prediction intervals.  \nConclusion: Antioxidants were associated with higher values for several semen parameters, though certainty was very low and prediction intervals were wide. PDE inhibitors and methyl donors showed numerically positive point estimates but with confidence intervals that included the null. Larger trials reporting live births are needed.  \n© 2026 American Society of Andrology and European Academy of Andrology.  \nAndrology, 2026; 14:1731–1756 1731  \n[https://doi.org/10.1111/andr.70266](https://doi.org/10.1111/andr.70266)  \n1  Introduction  \nMale infertility accounts for approximately 40%–50% of infertility cases worldwide [1] . Among affected men, a substantial proportion present with idiopathic infertility, defined as abnormal semen parameters without an identifiable cause after standard evaluation, including exclusion of varicocoele, infection, endocrine disorders, genetic abnormalities, and obstructive azoospermia, with female factor infertility excluded or controlled [2] . Management remains challenging, as no consistently effective therapy has been established.  \nPharmacologic and nutritional supplements are widely used to treat men with idiopathic infertility; agents such ","cbCaidQWNHmlyueV","https://ap.wps.com/l/cbCaidQWNHmlyueV","pdf",3495210,26,"English","# Introduction\n# Methods\n## Reporting Standards and","[{\"question\":\"What treatments does the systematic review evaluate in idiopathic male infertility?\",\"answer\":\"It evaluates pharmacologic and nutritional interventions, including antioxidants, PDE inhibitors, and methyl donors, and also summarizes hormonal agents narratively.\"},{\"question\":\"How were study results analyzed across different intervention classes?\",\"answer\":\"Semen parameters were pooled using three-level random-effects models stratified by mechanism of action, using Knapp–Hartung adjustment; certainty was assessed with GRADE.\"},{\"question\":\"What were the main findings for antioxidants and semen parameters?\",\"answer\":\"Antioxidants were associated with higher sperm concentration, progressive motility, total motility, and normal morphology, but certainty was very low and prediction intervals were wide, crossing the null for all outcomes.\"}]","Pharmacologic and Nutritional Therapies in Idiopathic Male Infertility - A Systematic Review and Meta-Analysis | PDF",1791757808,66]